Will drug-eluting stens have a major impact in prevention of restenosis after non-coronary interventions?

Drug-eluting stents (DES) have revolutionized the treatment of obstructive coronary disease and expanding their applications to the periphery is inevitable. However, a better understanding of stent-associated restenosis in the periphery is needed. 1) The restenosis rate is very different in various vascular beds and clearly very high in infrainguinal vessels.

The superficial femoral artery is probably the vascular bed that will be most in need of DES technology, given its long lesions and high restenosis rate. 2) The restenosis process in the periphery appears to continue beyond the six-month mark that interventional cardiologists are used to in the coronary vasculature. This is now seen in both renal and femoral vessels.

DES technology will need to take this into account, which might explain why a slow drug release might be better than a rapid release, as was seen in the SIROCCO trial. 3) A large percentage of patients with peripheral vascular disease have elevated baseline ... more.

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